The concept of cancer in our minds is mostly restricted to only the types of cancers that are fatal and are leading causes of death. However, cancer can happen to any part of the body and eyes are one of them. Cancer of the eye is rare and refers to any type of cancer that originates in the eye. It is classified based on the type of cell it starts in. The most common type of eye cancer is intraocular melanoma. 

Contrary to other types of cancers, there may not be any obvious symptom that indicate eye cancer and are most likely to be found out during any routine eye check-up. Few possible symptoms of eye cancer include bulging of one eye, loss of sight (partial or complete), lump on the surface of the eye and eyelids, blurry vision, change in the appearance of the eye, seeing spots or flashes, a dark spot in the iris and chronic inflammation of the conjunctiva. If the cancer has spread either to the outside or inside of the eye, then the patient may feel some pain too. Although these symptoms may be similar to other eye conditions, it is important to identify them and report them to the doctor. If the condition is diagnosed to be an eye cancer, an early detection will make it easier to treat and make the treatment process successful. 

Types of Intraocular Cancer

The eye has three major parts – the eyeball and the three main layers (retina, uvea and sclera), the orbit (tissues surrounding the eyeball) and adnexal (accessories such as eyelids and tear glands). Different types of eye cancer can occur in any of these parts. Intraocular cancers occur when the eye itself is affected.

There are two types of intraocular cancers – primary (cancer that originates in the eye) and secondary (when the cancer has spread to the eye but started somewhere else). 

The most common types of primary intraocular cancers are melanoma and non-Hodgkin lymphoma. In case of children, the most common intraocular cancers ate Retinoblastoma (cancer in cells in the retina) and haemangioma (a benign tumour of the choroid and retina that develops in the blood vessels). 

Intraocular Melanoma: 

Although the most common type of eye cancer in adults, it is still rare. When melanoma, a type of harmful skin cancer, occurs in the melanocytes in the eye, it is called intraocular melanoma. It can spread to the other parts of the body including nearby tissues or other distant parts in the body. It also affects the other tissues in and around the eye including iris, ciliary body, conjunctiva and eyelids. Exposure to UV rays and tanning beds, skin problems and age make it more likely for intraocular melanoma to occur, albeit rarely. The most common symptoms are blurry vision, soreness or bulge in the eye, seeing flashes in the vision, change shaped of the pupil or dark spot in the iris. After a detailed eye examination, the patient might have to undergo tests such as ultrasound scan, an angiogram (FA), biopsy, MRI and blood tests after a detailed eye examination to help diagnose and stage eye cancer. You might have them again during and after the treatment. These tests help the doctor decide whether you have eye cancer and if so, the best treatment for you. 

Conjunctival Melanoma: 

This is a type of tumour that develops in the conjunctiva and if left untreated, it may spread to the lymph nodes. There are chances of recurrence of this cancer and may appear on the surface of the eye in the form of a dark spot. 

Treatment of Intraocular Cancers 

The factors that help in determining the treatment plan are blood test results, size and location of the tumour and stage of the cancer, overall health, and ability to see with the normal eye. The aim of the treatment plan is to save the eye and cease the cancer from spreading to other parts of the body. 

Since there are chances of an eye damage in the course of treatment, doctors usually suggest to watch and wait if the tumour is not growing in size. The treatment options include surgical removal of the tumour and some small tissue surrounding the tumour, radiation, photocoagulation, or transpupillary thermotherapy (using heat to destroy cancer cells). 

Things to Remember

Intraocular melanoma is a rare form of cancer that affects the eye starts in the melanocytes in your eyes. Watch out for soreness in the eye, blurry vision, or any floaters in the vision, and protect eyes from UV rays. Wear sunglasses while stepping out in the sun. The symptoms may look like other problems but it is always better to consult an expert before it is too late. 

Dr. Pinaki Mahato, is the Director, Medical and Pediatric Oncology, HCG Cancer Centre Vadodara

Disclaimer: 

Articles authored by medical specialists reflect the professional opinions and expertise of the respective specialists. The views expressed in these articles are solely those of the author.  We do not endorse or take responsibility for any diagnosis, treatment, or advice provided in these articles. Always consult your healthcare provider for personalized medical guidance and treatment.